Drug interactions
Amitriptyline + Hydromorphone
Severity: Moderate
Amitriptyline and Hydromorphone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amitriptyline adds to the sedation, respiratory depression and anticholinergic effects of hydromorphone. Falls, confusion and constipation or urinary retention are more likely, particularly in older adults.
What this interaction means in plain words
Amitriptyline and Hydromorphone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Hydromorphone belongs to Musculoskeletal.
Why it happens
Additive CNS depression and anticholinergic effects.
What to do
Start with low doses and titrate slowly. Monitor sedation, breathing and bowel and bladder function.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Hydromorphone?
MediHelp rates the interaction as moderate. Amitriptyline and Hydromorphone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Amitriptyline adds to the sedation, respiratory depression and anticholinergic effects of hydromorphone. Falls, confusion and constipation or urinary retention are more likely, particularly in older adults.
How serious is the interaction between Amitriptyline and Hydromorphone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate slowly. Monitor sedation, breathing and bowel and bladder function.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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